How Somebody With Apo-Ε4/ε4 Gene Mutation Should Adapt Bulletproof Diet? (Save Me From Alzheimer A

Dear all!


I have a question which might seem to narrow, but in fact applies to 1.7% of population or millions of people.


I would, really, really, really appreciate your help.


I have done 23andme testing and found out that I have a relatively rare mutation in APOE (Apolipoprotein E) gene. Practically, it means that I have 6 times higher risk to get Alzheimer (which gets me to 40% chance). Basically, I hit both risk alleles. And I hit both twice. A little more information on APOE:


It affects lipid metabolism very strongly.


So, the question is how an APoE 4/4 carrier should eat for optimal health and good lipids? 


Some say that they should stop eating saturated fats, because since these carriers can't utilize fats properly, these become plaque in the arteries and brain (leading to Alzheimer's or atherosclerosis). 


The other half say that because we can't utilize them properly, we must eat more, otherwise the brain starves. Besides, coconut oil has shown to almost reverse Alzheimer's in some patients (although we don't know if these patients were 4/4 or not).


I found one study by Berkeley which seems legit. It strongly support the latter position and recommends that people APOE 4/4 people should minimize saturated fats and even omega-3 as these actually increase LDL (bad cholesterol).


So, how can I get both minimization of Alzheimer's risk and long-term heart health with healthy cholesterol numbers?



I have followed Paleo diet for quite a while. So I'm wondering how should I adapt it. Research is limited, but from what is available at the moment, I should eat a kind of high-protein, moderate-to-high carb and low-fat Paleo diet? 


I also train regularly (weightlifting) and supplement wih a good multiviamin (Pure Encapsulation Nutrient with K2 & methylation complex), Vitamin D3, fish and fermented cod liver oil. Occasionally, cycles of creatine, whey, glutamine, probiotics, Q10, Acetyl-L-carnitine.


What other lifestyle, diet and exercise modifications should I consider to minimize long-term risks both in terms of caridovascular & brain health?


  • M. ThomasM. Thomas A Stick of Butter a Day Keeps the Doctor Away.

    I wondered about this too when I first read about the phenomena a little while.  Your best bet is to probably find a doctor who believes in bulletproof principles and go from there.  Honestly, I don't think I could give you sound advice in good conscience. 

  • It would be really interesting to hear others' thoughts on the subject!

  • RodRod The Rodfather



    I'm so sorry you are in this bind but there is always a way so don't worry!!!!!



    My first question is: Have you done any blood work? Being Paleo and eating saturated fats should have your LDL high?

    Everything I learned about "biohacking" has been baby steps to "circadian biology", that's where the real biohacking comes in. You can buy a bunch of cool shit to "hack" but if you don't have context, you're not winning. Paleo is just a brand now and too many have opinions, it's on you to read and reread the material to not only find truth but to connect the dots. Much love to everyone who has helped me on my journey for restoring my health, please keep in touch. Feel free to message me with health questions [email protected] 

  • I just had a conversation with a Prof. Dr. Andro from and he shared several ideas fro APOe 4/4 that I would really love to hear others' opinions on. Here they are:


    - try to keep GSH up (NAC, Alcar, SAM-e), better regular low doses than high doses

    - keep working out for the rest of your life. 30 minutes of moderate exercise 5 days/week will reduce the negative effects of APOE4 on plaque formation => (you can reduce your risk to that of anyone else by just working out)

    - Stay clear of EPA (higher EPA = lower HDL for you; cf.

    - mixed results for DHA (higher small LDL here ( but better TRIGs + cholesterol here (

    - stay clear from saturated fat, as well because it increases your CRP (marker of inflammation)

    - really nothing conclusive on MUFAs

    - as for the MCTs 90% quack results and very little controlled science on "coconut miracles" out there.


    Would love to hear your thoughts!
  • M. ThomasM. Thomas A Stick of Butter a Day Keeps the Doctor Away.

    Intersting.  You talked to the SuppVersity guy in person or through e-mail or what?  I am a huge fan of that blog.

  • edited March 2013

    Intersting.  You talked to the SuppVersity guy in person or through e-mail or what?  I am a huge fan of that blog.


    Blog is great, indeed. I have just sent a message via Facebook and has been surprised to get a quick response.

  • Hi all, thanks for the good leads and info on this topic.  Here is my contribution as a fellow 4 carrier. 


    First is a general point.  Apoe4 is the so called Alzheimer's Gene.  But CAD risk is much easier to track than AD risk.  But my father is now a sad shaddow of his former self due to AD.  His mother also went down the same route.  To see a great academic fall apart like this is worse than heart disease.  So first I would say steer clear of low fat advocates such as Pam McDonald who are just interested in cutting your cholesterol.  Our brains need fat! But we need to keep an eye on all our CAD markers


    Second I approached Stephanie Senef of MIT.  She is really interesting and writes great stuff on Alzheimers, Autism and diet.  She gave me her diet for avoiding both CAD and AD. Her thoughts on sunlight and sulfur are truly interesting and worthy of a podcast...



    1) eat a diet that's rich in sulfur-containing

    foods.  This includes seafood, eggs,

    cruciferous vegetables, onions, garlic and cheese.


    2) get as much sun exposure to the EYES as you can.

    Especially blue light -- I.e., gaze at the blue sky when you're outdoors.  This will only work if you have enough

    sulfur, but I believe that the eyes can provide sulfate to the brain, but they

    need blue light to do so (because the flavins FMN and FAD that are involved in

    the process of producing sulfate respond to blue light).


    3) Eat a strictly organic WHOLE FOODS diet -- i.e., cook

    your own meals.

      Don't eat

    anything that comes in a box.  Don't eat

    anything that has high fructose corn syrup or canola oil in it.  Avoid soy and corn products, because they are

    likely to be GMO.


    4) Don't take a statin drug, regardless of your

    cholesterol levels.


    5) eat a lot of flavonoids such as curcumin (curry

    powder), resveratrol (in wine), chocolate, coffee, tea, and bright colored

    fruits and vegetables.  Choose only

    organic versions!!


    She thinks this lifestyle will protect you from both heart

    disease and Alzheimer's; especially if, when you get sun exposure to the eyes,

    you also get it to the skin. Both the heart and the brain are desperate for

    sulfate, and sun exposure is the easiest way to get it.  Glyphosate (Roundup) likely disrupts the process that makes sulfate

    AND the process that transports it.  90%

    of the GMO's are engineered to be "roundup ready" -- I.e., they don't

    die when Roundup is sprayed on them.

    Postmortem studies of Alzheimer's brains show a severe

    deficiency in a single lipid molecule -- sulfatide.  This molecule contains a sulfate anion

    attached to it, and I think it's the only fatty acid for which this is true. It

    ordinarily makes up 6 to 7% of the total lipid content in the brain, so it's

    very important.

    She also mentioned scepticism about MCT oil - she prefers the whole food - ie eat coconuts.  Yes I will eat them but also stick to my Bulletproof coffee.


  • edited March 2014

    Know this is an older post, but here is a handy reference for the effects the different Apo-E genotype combinations will have on individuals:


    Further excellent analysis of this here:


    The plus side of having E4 is that it supposedly gives you better episodic's yours?


  • JustaGuest and Landlover, sorry for your unfortunate circumstance.  I had to look mine up in 23andMe a few months ago just to make sure, and I am 3/3 and my husband is 2/3.  I still am looking for genetic clues, though, about my optimal diet and find that the available information is still pretty limited.

    These would be my suggestions.  Eat a lot of fish and seafood.  Omega 3 fats might be your lifesaver.  Also, you have some great BP/Paleo monounsaturated fat choices:  olives/olive oil, macadamia nuts, and avocados.  

    For exercise, try yoga or something low impact (walking/hiking) that helps with stress.  Also, don't forget your cardio, maybe HIIT workouts would be beneficial.  Exercise is supposed to be the top thing one can do to prevent Alzheimer's,


    Good luck to you.


  • Interesting AHS16 talk by Dr. Stephen Gundry talking about APOE4 and diet.

  • @Fatdude said:
    Interesting AHS16 talk by Dr. Stephen Gundry talking about APOE4 and diet.

    Great talk, answered most of my Qs. I'm a big fan of Dr Gundry. Cheers :)

  • This doesn't make sense to me. An increase in LDL particle size is suppose to be good. Here he claims the study found that to be a negative. If he is talking about LDL Particle Number this is needlessly confusing. Anyone confirm this? I know that the large LDL is preferable to the smaller size LDL and that the LDL Particle Number is, according to conventional thought at this time, best on the low side. I'm a 4/4 and this is especially important so I want to get it right. Anyone out there that can help clear this up?

  • edited March 2017

    I've got a hetero APOE4 and I think the best route to "avoid" is completely elusive, and requires more than just a determinist type mindset. Meaning: let's say your risk factor is huge, but nobody in your immediate family has had AD, should you still be a worry wart?

    Plus, there's docs out there like on the Bredesen protocol that basically promote a ketogenic diet as one highly helpful for AD given that it's a anti-inflammatory based diet. Essentially AD is an inflammatory disease and if Keto is controlling the proper biomarkers, what's to fear in saturated fat?

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